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What's to know about barrel chest?

Barrel chest is a condition in which the chest appears to be partially inflated all the time, with the rib cage broadened as if in the middle of a deep breath. The person may find it hard to breathe normally.

While people sometimes give the description "barrel-chested" to people with large chest muscles, a barrel chest in a medical sense may be the result of arthritis or chronic obstructive pulmonary disease (COPD), a group of diseases that cause serious respiratory problems.

While the condition does not always require medical treatment, when a barrel chest is the result of COPD it may become necessary to manage breathing symptoms.

Around 16 million people in the United States have COPD. This article explores the causes of barrel chest and discusses how to prevent the onset of factors that can lead to barrel chest.

Causes

In an adult, a barrel chest is normally associated with either osteoarthritis or COPD. In children, it may be linked to cystic fibrosis or chronic asthma.

Osteoarthritis

A person with osteoarthritis can develop a barrel chest.

Osteoarthritis (OA) is a disease that causes the cartilage at the ends of bones to break down.

People sometimes describe OA as the "wear and tear" type of arthritis, because it usually develops slowly and most often occurs in older adults.

A barrel chest can develop if OA develops where the ribs meet the spine. Stiffness occurs and the joints in the ribs lose their flexibility. Eventually, the ribs might appear to be stuck outwards.

The condition most often occurs in the spine, hands, hips, and knees. Stiffness and swelling are two of the most common symptoms.

COPD

Barrel chest often results from COPD, a respiratory disease that includes emphysema and chronic bronchitis. It is a serious condition that gets worse over time. A person with COPD may not be able to achieve full function without on-going care once the condition reaches its end stage.

The National Heart, Lung, and Blood Institute (NHLBI) notes that COPD is the third-leading cause of death in the United States.

Individuals with COPD find it harder to breathe as time progresses. This is because COPD damages the lungs in four different ways:

The different parts of the lungs become less able to stretch or to expand and contract.

Damage occurs in the walls of the air sacs, or alveoli, where the exchange of oxygen and carbon dioxide takes place.

The airways or passageways through the lungs become irritated and swollen.

Extra mucus is produced and clogs the airways.

The chest area may change shape to resemble a barrel, and the shape of the diaphragm, a key muscle for moving air and an out of the lungs, will also change. It loses some of its length and thickness and weakens.

If the lungs do not have full function, it can be difficult for someone to inhale or exhale completely. The lungs remain partially inflated most of the time, and the rib cage stays expanded.

This state of hyperinflated lungs can result in a barrel chest, normally during the later stages of COPD.

Individuals with a barrel chest from COPD may appear as if they are about to take a very deep breath, even though that this is often a difficult action to complete for people with the condition.

Cystic fibrosis

This is a genetic condition during which mucus builds up in organs throughout the body. In 75 percent of children with CF, diagnosis occurs before the age of 2 years.

Mucus in the lungs can lead to frequent infections and lung damage, sometimes resulting in a barrel chest.

Studies of children with severe cases of asthma also suggest a strong link between hyperinflated lungs and the development of a barrel chest. Children with a barrel chest may also experience slower growth rates.

People with CF will use physical therapy techniques on the chest and back that help to loosen mucus on the lungs alongside many of the above medications.

However, even people who use treatment methods to restore quality of life after the development of barrel chest will not be able to reverse the symptom. The underlying diseases are progressive and symptoms very often do not improve.

Prevention

Taking steps to reduce the risk of the diseases in COPD and osteoarthritis is crucial to preventing the restrictive effects of barrel chest.

Wear the appropriate protective gear when spending time around chemicals and pollutants, for example when in the workplace or at home.

Preventing osteoarthritis

The maintenance of an active lifestyle and healthy body weight plays a key role in strengthening the cartilage and reducing the risk of OA. Excess body weight can place strain on the joints and tendons.

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